CMS Announces Part D Enhanced Medication Therapy Management Model

The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation(CMMI) is introducing the Part D Enhanced Medication Therapy Management (Enhanced MTM) Model, which will aim to free up stand-alone Part D Prescription Drug Plans (PDPs) in specified regions of the United States. This model will commence January 1, 2017 with a five-year performance period, and it will serve as a unique enhanced medication therapy management (MTM) program, waive current requirements for enrollment and offer a reward for meeting certain cost-reduction parameters.

According to CMS, Enhanced MTM is intended to assess whether providing selected Medicare Prescription Drug Plans (PDPs) with additional incentives and flexibilities to design and implement innovative programs will better achieve the overall goals for MTM programs. These goals include:

  • Improving compliance with medication protocols, including high-cost drugs, to ensure that beneficiaries receive the medications they need, and use them properly
  • Reducing medication-related problems, such as duplicative or harmful prescription drugs, or suboptimal treatments
  • Increasing patients’ knowledge of their medications to better achieve their or their prescribers’ goals of therapy
  • Improving communication among prescribers, pharmacists, caregivers and patients

Comments, questions and responses regarding this model can be sent to EnhancedMTM@cms.hhs.gov. The inquiry should identify the sender and the organization represented and be submitted by October 16, 2015 to receive full consideration.

CMS will be holding a webinar October 21, 2015 at 2pm (EDT) to provide further details. For more information about the webinar, visit http://innovation.cms.gov/initiatives/enhancedmtm/index.html.

 

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